There is no single cause of liver cancer. The most common primary liver cancer in adults is hepatocellular carcinoma, often called HCC. It frequently develops in the setting of long-term liver disease, including hepatitis B or C infection and cirrhosis. A risk factor raises the chance of cancer; it does not mean cancer is certain.
Did the cancer start in the liver?
Primary liver cancer begins in the liver. Cancer that started in another organ and later spread to the liver is different: it remains a cancer of its original site. For example, colon cancer that has spread to the liver is still colon cancer. This distinction matters when you talk with your care team about the diagnosis and possible options.
If someone says “liver cancer,” ask for the exact cancer type and whether it started there. The same location on a scan can have a different meaning depending on where the cancer began.
What raises the risk of primary liver cancer?
Several conditions and exposures are linked to a higher risk of HCC:
- Long-term hepatitis B or hepatitis C infection.
- Cirrhosis, which is long-lasting scarring of the liver, and heavy alcohol use.
- Nonalcoholic steatohepatitis, or NASH, a form of fatty liver disease with inflammation.
- Smoking, certain rare inherited disorders, and exposure to aflatoxin B1 in contaminated stored foods.
These factors do not affect everyone in the same way. Some people with one or more risk factors never develop liver cancer, while others who have liver cancer have no known risk factor. A clinician can help explain what is relevant to an individual person's history.
Understanding your own diagnosis
A discussion of risk factors is not the same as finding the cause of a particular tumour. Ask what the available tests show about the cancer and the liver itself. If there is an underlying liver condition, ask how it affects the conversation about care. You can request an explanation of any unfamiliar terms in your reports and ask which findings are still uncertain.
Questions to bring to an appointment
- Is this a cancer that began in the liver, or has it spread from elsewhere?
- What is its exact type, and which tests established that?
- Do I have a liver condition that also needs to be considered?
- How do the cancer findings and liver health affect the options we discuss?
- What information should I bring to the next conversation?
Further reading
National Cancer Institute: What Is Liver Cancer?
National Cancer Institute: Liver Cancer Causes and Risk Factors